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Chapter 10 Appointments and Schedules 201
Figure 10-4 is an example of a typical appointment
card or reminder card.
Computer-scheduling software also can print appointment cards for you. If you write them by hand, use
ink that can’t be erased. If the patient needs a series of
appointments, try to make them for the same time and
on the same day of the week. If there’s space on the card,
you could list the whole series of appointments on it. But
it’s probably better to give the patient a card for his/her
next visit only. Just give him/her a new card after each
visit. Handing out all the cards for a series of visits can
lead to confusion and lost cards.
Telephone Reminders
Patients also should receive a telephone reminder or
conrmation call 1 or 2 days before their appointment. Some computer scheduling software will call
patients automatically with a recorded reminder
message.
Whether you make the call or whether it’s made
by computer, call only the patient’s home number.
Don’t call a work number unless the patient asks
you to do so. Document the patient’s preferences in
the chart so everyone in the office can see this information. Federal privacy laws allow you to leave an
appointment reminder message on a patient’s answering machine or with whoever answers their home
phone. But it’s still a good idea to ask the patient if
that is okay. You should ask at the time you make the
appointment.
Don’t leave a message on a patient’s work phone
or with a coworker, even if the patient has asked you
to call her there. Leaving a message at work isn’t
a good idea. It raises privacy concerns that usually
don’t exist when you make reminder calls to the
patient’s home.
Don’t ever include the reason for the visit in a reminder
message. If a person answers the phone and wants more
information, politely decline to give it. Tell the person
that patient privacy issues don’t allow you to answer the
question.
Recorded messages left by the computer should have
the same basic content. They should include a callback number if the patient can’t keep the appointment.
Include a callback number when you leave a reminder
message, too.
Reminder Cards
Your ofce may send reminder cards or letters instead
of making phone calls. These cards also can be used
for patients who don’t want phone reminders. You
should mail the reminder card at least a week before the
appointment date.
Some ofces use reminder cards to alert patients that
it’s time for some annual exam, such as a Pap smear,
mammogram, prostate exam, or complete physical. For
privacy reasons, however, the reminder card should
never state the kind of exam. It should have a general
message printed on it. Here’s an example:
“According to our records, you are due for your
annual visit. Please call the ofce and we will be glad to
make an appointment for you.”
For privacy reasons, some patients may want their
reminder cards mailed inside an envelope. This is a reasonable request, and you should provide this method
of sending. You also should accommodate a patient
who wants the card mailed to a place other than his
home. Write only the appointment date and time on the
reminder card, never the reason for the visit. Remember,
you have no way of knowing who will see the card after
it’s been mailed.
Reminder calls and cards help patients remember their
appointments. If they need to cancel or reschedule, you
may be able to ll that slot with another patient. Keep a
list of names and phone numbers of patients who have
asked to be called if an earlier appointment becomes
available. You might call this a cancellation list, a waiting list, or a move-up list in your ofce. Many computerized scheduling systems offer a waiting list option.
C
O
G
ADAPTING THE SCHEDULE
Sample Telephone Reminder
Your reminder call should be brief. Simply state your
name, your ofce, and the date and time of the appointment. For example, you might say:
“This is Ms. Palmer from Dr. Reid’s ofce. I’m call-
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ing to conrm your appointment for tomorrow,
Thursday, February 10, at 3:30 .”
Unless the patient has a question, just say, “Thank
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you and goodbye.”
You should write “conrmed,” “left message,” or “no
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answer” on the appointment schedule to show the
results of each call.
It will be an unusual day in the ofce if everything
goes according to plan. Often, patients will be late for
appointments or even miss them altogether. Providers
may experience delays. Patients who don’t have appointments may call the ofce with emergencies. You may
have to adjust the appointment schedule when these
things happen.
Emergencies
When a patient calls with an emergency, rst nd out
whether the problem can be treated in the ofce. Every
ofce should have a policy for evaluating emergency calls.
202 Section III Administrative Medical Assistant Skills
Figure 10-5 When a patient calls from home with a
possible heart attack, you will call 9-1-1. (Reprinted from
Kronenberger J, Ledbetter J. Lippincott Williams & Wilkins’
Comprehensive Medical Assisting. 4th ed. Philadelphia,
PA: Wolters Kluwer; 2013.)
Sending Patients to the ER
Follow your ofce policy, but in general, you should put
through to the ofce nurse or physician any caller who
complains of these symptoms:
Chest pain
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Shortness of breath
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Loss of consciousness
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Severe bleeding
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Figure 10-5 shows a patient calling the ofce from his
home. This patient will need emergency care.
Most likely, patients with these symptoms need to be
seen in a hospital emergency room (ER).
Constellation of Symptoms
When certain symptoms occur together, it can signal a
specic problem. Such a group of complaints is called
a
constellation of symptoms. Keep the following
in mind:
Severe pain in the lower right abdomen, nausea, and
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fever is the constellation of symptoms for appendicitis.
Chest pain, shortness of breath, arm or neck pain, and
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nausea and/or vomiting is the constellation of symptoms for a heart attack.
Severe headache, dizziness, trouble speaking or see-
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ing, and numbness or weakness of the face, arm, or
leg is the constellation of symptoms for a stroke.
If a patient needs to be seen the same day and no
appointments are available, you can adapt the schedule
in three possible ways:
Work in the patient between existing appointments.
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This will result in delays for patients with appointments that follow, but the emergency may need to be
addressed immediately.
Schedule the patient in an open slot you have created
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as catch-up time in the schedule. Keep in mind that
some emergencies may require quicker attention.
Schedule the patient into a lled time slot, and then
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call that person and reschedule his or her appointment. Explain that an emergency requires you to do
this. This may not be a good alternative, however, if
the emergency patient needs to be seen quickly.
Acutely Ill Patients
Seen in the Ofce
Here are some typical symptoms that would require the
patient to be seen in the ofce the same day. Again, the
policy in your ofce will be the nal word on how to
handle these cases.
Severe vomiting for more than 2 days
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High fever for more than 2 days
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Severe headache with neck stiffness
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Abdominal pain with symptoms of appendicitis
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Wounds that don’t require a trip to the ER
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Study Skill
Repetition is a great way to instill information into
your memory. Repeatedly write words that are new
to you. Once you have mastered the word, practice
writing the word with its denition. Soon, you will
be able to recognize and understand words or terms
that were once strange to you and not part of your
vocabulary. This is especially important to help you
learn medical terms and names of drugs.
You’ll also receive calls from patients who are seriously
ill but don’t have a true emergency. These patients need
to be seen as soon as possible, but not necessarily that
very day. You should triage these calls in this way:
Get as much information about the patient’s problem
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as you can. Write a note containing this information.
This will help the physician decide when the patient
should be seen.
Place the patient’s chart with the note in the place the
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physician has chosen for such calls.
Tell the patient you’ll call back as soon as the physi-
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cian makes a decision.
Once again, your ofce policy will determine how
calls like this are handled. Here are some examples of
complaints from patients who need to be seen soon,
although not necessarily that very day.
Severe sore throat
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Severe back pain
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Burning and/or painful urination
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Headache lasting more than 3 days
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Jaundice that has appeared in the last week
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Chapter 10 Appointments and Schedules 203
Severe respiratory symptoms of more than a week
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Severe rash lasting more than 3 days
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Heart palpitations for more than 2 days
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If the physician wants to see the patient, he will tell
you how soon. You can adjust the schedule using the
same system you use to work in emergency patients.
Acutely ill patients don’t need to be seen as quickly,
however. So if you must cancel a scheduled appointment
to work in an acutely ill patient, try not to do it for
the same day. This is because you might not be able to
reach the patient you’re cancelling in time. You do not
want that person showing up in the ofce only to nd
that her appointment was cancelled. But if you cancel an
appointment for the next day, you can call the patient’s
home and leave a message that she’ll probably get.
Most importantly, remember that the physician or
the triage nurse always should make the nal decision
when adjusting the schedule for an emergency.
Other Schedule Busters
Other events that will require you to adapt the schedule
may be more common.
Walk-In Patients
Walk-ins are patients who come to the ofce without an
appointment. Your ofce may have a procedure for handling these patients. But in general, you must rst nd
out why the patient has come in. If it’s an emergency, the
patient should be seen immediately. Otherwise, have the
patient sit in the waiting room while you tell the physician. The physician can then decide whether to see the
patient or ask him to make an appointment.
If the physician is going to see the patient, explain
that you’ll work him in as soon as possible. When the
patient leaves after being seen, apologize for the delay.
Suggest that he make an appointment next time.
The Late Patient
Patients who are late can cause problems in the schedule
for the rest of the day. You should remind the patient
gently but rmly that she was late and tell her the physician is with another patient. Offer the patient the choice
of waiting or rescheduling the appointment.
Some ofces have a policy requiring that patients
who are more than 15 minutes late be rescheduled. Of
course, late patients may not always be a problem. If
the physician is running behind, a late patient may have
arrived before it’s his turn to be seen.
One thing you might do is schedule patients who
have a habit of being late toward the end of the day.
That way, their lateness will affect the day’s schedule
less. Also, you can ask patients to call the ofce if they
know they are going to be late.
Always call patients with a history of being late to
remind them of their appointment. You should do this
even if it’s not normally ofce policy to make appointment reminders by phone.
Case Question
Recall our case study, Matt McNeil was a new
patient to our ofce. Since that time, he has
been scheduling routine follow-up appoint-
ments. Unfortunately, he has arrived so late to
his last three appointments you have had to can-
cel and reschedule his appointments. Currently,
Mr. McNeil is calling to request an afternoon
appointment, what is the best way to handle
this situation?
Perhaps the best way to handle this situation is to
rst explain that he has been late to the last three late
afternoon appointments and has had to reschedule.
You could suggest an appointment earlier in the day.
Unfortunately, patients don’t always realize how much
they affect the physician’s schedule when they arrive
hours after their appointed time.
The No-Show Patient
A no-show occurs when a patient misses an appointment and doesn’t call the ofce ahead of time. When
this happens, try to call the patient to nd out why the
appointment was missed. Then, try to reschedule the
patient for another day. It’s essential that information
about no-shows be documented in the chart as well as
on the daily schedule. Use red ink when marking a noshow on the daily schedule and the patient’s chart.
You should make notes in the patient’s record of
all actions involving missed appointments. Copies of
any letters sent to the patient should be included in the
chart too.
The information in both the appointment schedule
and patient’s chart must look the same. This is vital
information for legal issues as well as for the patient’s
welfare.
If you cannot reach the patient by phone, send a card
asking him to call the ofce to reschedule. Write in the
patient’s chart that the appointment was missed. Also,
note if you rescheduled the appointment or mailed a
card for the patient to reschedule.
Tell the physician about patients who continually
miss appointments. She may want to call the patient or
send a letter of concern for the patient’s welfare. This
is especially true for patients who are seriously ill. In
extreme cases, the physician may want to end the relationship with the patient.
204 Section III Administrative Medical Assistant Skills
Cancelled Appointments
Here’s what to do when a patient cancels an appointment.
Ask the patient why she is cancelling.
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Mark the cancellation on the appointment schedule.
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Note the cancellation and the reason in the patient’s
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chart.
Offer to reschedule the appointment at another time.
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If the physician is seeing the patient for a continuing
medical concern, make sure the patient understands the
importance of rescheduling. The patient may say she’ll
call later to reschedule. Make a note to yourself to check
on the callback in a few days.
If a patient cancels and you have a full schedule, no
action is needed. But if the schedule is light, use your
wait list to try to ll the opening.
Documenting Missed Appointments
You should note missed appointments, whether they’re
cancellations or no-shows, in the patient’s record. Also,
include a summary of the reason for the missed appointment. Here is an example of a note in a patient’s chart:
Mrs. Parrish was called regarding missing scheduled
appointment for today at 9:30 . Patient said she forgot
about the appointment. Appointment was rescheduled
for 10/15/07 at 10:00 . Patient was advised of the need
to have regular prenatal checkups. Patient verbalized
understanding. Dr. Wong was notied that appointment
was missed and rescheduled.—Noreen Brooks, CMA
Ofce Cancellations
The ofce may have to cancel patients’ appointments
if the doctor is ill, has an emergency, or takes personal
time off. Patients don’t need to be told the specic reason for the physician’s absence. Cancellation by the
ofce should be noted in a patient’s record too. Here are
some guidelines to follow:
If you have advance notice: Write a letter to patients
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with appointments you must cancel. Simply state that
the physician will be away from the ofce and will
return by a certain date. Ask the patient to call the
ofce to reschedule. Remember to place a copy of the
letter in the patient’s chart.
If you must cancel on the day of the appointment:
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Call the patient. Explain that the physician has been
called out of the ofce unexpectedly. Try to reschedule the appointment while the patient is still on the
phone.
If the patient arrives before you can contact him:
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Apologize and politely explain the situation. Most
patients understand this situation.
When the physician won’t be available for a long
time, another physician must cover the practice or be on
call. If a substitute physician is employed, ofce appointments won’t be disrupted.
You also should have a list of the names and addresses
of physicians who are on call to see patients. Give this
information to patients you must cancel, if your ofce
policy allows it.
When the Schedule Doesn’t Work
You’ve been doing everything right. You follow ofce
procedures for scheduling new and established patients.
You remind patients of their appointments. You’re using
scheduling strategies with frequently late patients, and
you try hard to ll slots created by cancellations. You
expect that some days will not run smoothly. But the
schedule seems in chaos almost every day, and you just
can’t gure out why.
This situation is a case where a study might help.
Here’s what to do:
Look at the schedule over the past 2 or 3 months.
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List all the patients seen, when they arrived, how long
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they spent with the physician, and when they left the
ofce.
Your study might show that many patients are
arriving late or that not enough time is being allowed
for certain procedures. Perhaps too many staff members are allowed to make patient appointments.
Maybe a physician who is frequently late is part of
the problem.
Some problems may never be solved completely. But
if you can identify them, you often can make changes so
their effects will be less severe.
The Physician Has Been Delayed
Sometimes, the physician will arrive late to the ofce. If
his appointment hours have not yet started, call patients
with early appointments. Give them the choice of coming in later or on another day.
If patients are waiting, tell them at once that the
physician has been delayed. Also tell them how long
the delay is expected to be. Ask if they want to wait or
reschedule for another time. If patients reschedule, be
sure to note the reason in their chart.
C
O
G
The physician may want a patient to see another doctor, perhaps a specialist in another eld of medicine. The
patient also may need to be sent to another ofce or
facility for testing or to be admitted to the hospital. In
each case, you may need to make the appointment with
the other provider.
APPOINTMENTS WITH
OTHER PROVIDERS
Chapter 10 Appointments and Schedules 205
Third-Party Payers
When making an outside appointment, you must rst be
sure it meets the requirements of
are the insurance companies, HMOs, and other health
care plans that pay patients’ medical bills. You should
know that managed-care companies, such as HMOs, have
guidelines for sending patients to other providers. The
requirements are called
precertication. This means the
insurer must approve the appointment in advance.
Call the phone number on the patient’s insurance
card before making these kinds of appointments:
Sending the patient to another physician
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Scheduling certain tests or procedures
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Admitting the patient to the hospital (This only
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applies to admissions that are not emergencies.)
The third-party payer may require completion of a
referral form. See Figure 10-6, a sample referral form.
The Preferred Provider
Be sure the provider you’re calling is a preferred provider
for the patient’s health care plan. These are physicians,
REFERRAL FORM
This form must be completed in full or treatment of the patient may be delayed.
ALL INFORMATION IS STRICTLY CONFIDENTIAL AND WILL BE HELD BY THE AREA HEALTH SERVICE.
PATIENT DETAILS: Interpreter Required: YES / NO
TITLE
MEDICARE NUMBER
ADDRESS
COUNTRY OF BIRTH
FIRST LANGUAGE SPOKEN
GENERAL MEDICAL
PRACTITIONER NAME:
MEDICAL SPECIALIST
NAME:
Referred to:
Specialty:
History and Reason for referral:
SURNAME
third-party payers. These
LSW HEALTH
GIVEN NAME
HEALTH CARD NO
DOB
POST CODE
HOME TEL
MOBILE
BUS TEL
CONTACT TEL:
CONTACT TEL:
Enclosures Medical Documents: Yes No
Specialists Reports: Yes No
hospitals, and others that are in the plan’s approved network of providers.
Unless you send the patient to a preferred provider,
the plan’s payment will be less. Also, if a referral, test, or
hospitalization requires precertication and you don’t
have it, the health care plan may not pay at all. In each
case, both the patient and your employer could suffer
nancial losses.
Consultations and Referrals
Sometimes, the physician will want you to schedule
a consultation or a referral for a patient. You need to
know the difference between the two. In a consultation,
the physician wants another physician’s opinion about
the patient. The second physician reviews the patient’s
records and usually examines the patient. He then recommends treatment. In a
referral, the patient’s care and
treatment is actually transferred to the other physician.
Precertication
A health care plan will want certain information before
granting approval to send a patient to another provider.
Each plan will be different. But in general, you should
have this information ready when you call a patient’s
plan for approval:
The information on the patient’s plan ID card
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The patient’s name, address, phone number, and age
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If the patient is a family member of the insured, her
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relationship to the insured
The name, address, and phone number of the pro-
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vider asking for the approval
The name, address, and phone number of the pro-
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vider to whom the patient will be sent
The patient’s diagnosis or symptoms
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The type of care being sought
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If the patient is being admitted to a hospital, the name,
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address, and phone number of the hospital
Significant Medical History: (include any relevant access issues or special requirements)
(Signature) (Printed Name) (Date)
REFERRING CLINICIAN:
Provider Name: Provider No:
Address:
Telephone: Fax: Email:
Figure 10-6 Sample referral form. (Reprinted from
Kronenberger J, Ledbetter J. Lippincott Williams & Wilkins’
Comprehensive Medical Assisting. 5th ed. Philadelphia,
PA: Wolters Kluwer; 2016.)
You will need to get the health care plan’s approval
rst, unless the patient is being sent as an emergency
case. In that case, you should call for approval as soon
as you can.
In a consultation, the patient’s physician carries out
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the treatment, not the other physician. One required
part of a consultation is a consultation letter or report
from the consultant to the primary care physician.
In a referral, the patient’s care and treatment is actu-
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ally transferred to the other physician.
In some cases, the patient will want to make his own
appointment with the other physician. If so, ask the
patient to call you when the appointment is made. Write
the date and time the patient gives you in the patient’s
chart.
206 Section III Administrative Medical Assistant Skills
Diagnostic Tests
A physician in your ofce may want to send a patient
to another facility for testing. You’ll make some of these
appointments while the patient is still in the ofce. This
is especially true for labs tests and x-rays. Check with
the patient for any scheduling conicts she might have.
Types of Testing
Some of the tests you might send a patient out for are
as follows:
Laboratory tests (mainly blood tests)
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Radiology (x-rays)
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Computed tomography (CT scans)
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Magnetic resonance imaging (MRIs)
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Nuclear medicine studies
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Be sure to follow the policies of the hospital or out-
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patient facility about preadmission testing. These
may include blood tests, x-rays, and a donation of the
patient’s own blood in advance.
List all the appointment dates, times, and places the
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patient needs to go. Give this list to the patient. Make
sure the patient understands where to go, when, and
what will happen in each place.
Finally, write the name of the surgical facility and the
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date and time the surgery is scheduled in the patient’s
chart. You may need to arrange for hospital admission by providing this information to the hospital
admitting department.
C
O
G
THE PHYSICIAN’S
SCHEDULE
Testing Results
Find out exactly what test or tests the physician wants
and how soon she needs the results. Give the patient a
lab or x-ray referral slip with the requested tests marked
on it. Be sure to tell the provider if the results are needed
STAT, which means immediately. Also, give the patient a
slip with the outside facility’s name, address, and phone
number and the date and time of his appointment.
Some tests may require advance preparation by the
patient. Tell him what he must do, and also give him
written instructions. Be sure he understands the importance of following them.
Write the appointment time and date and the name
of the outside facility on the patient’s chart. Also, put a
reminder note in your appointment schedule to check
for when the test results are back. Some tests, such as
CT scans and MRIs, may require precertication by the
patient’s health plan.
Scheduling Surgery
You also may have to schedule procedures in a hospital operating room or an outpatient surgery facility.
You may have to get precertication for these from the
patient’s health care plan too. When scheduling surgeries, you’ll need to follow these additional steps as well.
Tell the surgical facility the exact procedure, the type
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of anesthesia required, and the time needed. The physician will provide this information. Also, give the
facility any other information and instructions your
physician provides.
Provide the patient’s age, health care plan, and the
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plan’s approval number for the surgery.
Give patients going to the hospital a preadmission
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form, if you have a supply from the hospital in your
ofce, or give instructions on how to complete online
registration.
Your scheduling duties will extend to the physicians
in the ofce as well as the patients. You probably will
help manage the physician’s professional schedule. This
includes allowing time in the appointment schedule for
the physician’s other professional activities. It also may
involve making travel arrangements for the physician.
Managing the Physician’s Time
You are already helping manage the physician’s time
when you create the matrix for the appointment schedule. The matrix sets time aside for the physician’s activities outside the ofce, including surgeries and hospital
rounds.
Another duty may be to screen visitors for the physician:
Pharmaceutical sales representatives can be a valuable
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resource for a physician. They provide information
about new drugs that are available. Ask the physician for a list of pharmaceutical sales reps he wants
to see. This probably will depend on the physician’s
specialty. A cardiologist and a psychiatrist would not
be interested in the same kinds of drugs, for instance.
Medical suppliers are another valuable source of
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information. But which suppliers are worth seeing
also depends on the physician’s specialty. For example, an internal medicine doctor wouldn’t want to
spend time with a supplier of articial hips and knees.
Ofce suppliers and suppliers of medical forms usu-
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ally meet with the ofce manager. They should not
be allowed to take up the physician’s time unless
she wants to see them. The same is true of insurance
salespeople.
Community leaders and fundraisers may arrive to
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ask for the physician’s support for some local project. Your medical ofce probably has a general policy
for handling them. Find out if the physician wishes to
be notied of these types of visitors. Bluntly refusing
Chapter 10 Appointments and Schedules 207
to help is not good for community relations. Instead,
you might tell them of the physician’s current community activities. If appropriate, explain that he cannot take on any more at this time.
Making Travel Arrangements
Many physicians attend professional meetings and educational conferences to keep current in their eld. You
may have to make arrangements for physicians in your
ofce to attend such events.
Create a one-page travel prole for each physician.
Here’s the information you’ll need:
The names and phone numbers of travel agents the
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physician prefers.
The airline(s) on which the physician likes to travel.
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Include his frequent ier number(s), preferred class
(e.g., rst class or coach), seating preference (e.g., aisle
or window seat), and ticket preference (paper ticket
or ticketless travel).
Rental car preferences, including the rental company
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and type of car preferred (compact, standard, SUV,
luxury, etc.).
Preferred hotel accommodations, including price
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range, bed size, and features (swimming pool, restaurant, tness facility, etc.).
The physician’s or ofce’s credit card number(s).
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When the physician tells you that she wishes to
attend a certain conference, complete the registration
form as soon as possible. Once you have conrmed the
physician is registered, make the travel arrangements.
You may do this through a travel agent, or you might
make the reservations yourself using the Internet. In
either case, use the information from the physician’s
travel prole to arrange a ight, hotel, and, if needed,
a rental car.
If you use a travel agent, he will provide an
This is a detailed plan of the trip. You will need at least
three copies of the itinerary.
Give the rst copy to the physician to carry on the trip.
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The second copy is for the physician to leave with his
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family.
Keep the third copy in the ofce, in case you need to
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contact the physician.
itinerary.
Being Your Own Online Travel Agent
If you make the travel arrangements using the Internet,
you will have to prepare the itinerary yourself. Here’s
what you should include:
Air travel: the date of the ight, airport, airline, ight
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and seat number, and departure and arrival times.
Unless the ight is nonstop, do the same for the connecting ight(s). You also will need to provide this
information for the return trip.
Rental car: the rental company’s name and phone
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number, reservation conrmation number, and type
of car reserved.
Hotel: the name and address, phone number, reserva-
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tion conrmation number, and dates of the stay.
Meeting or conference: name, location address and
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phone number, room number, and registration conrmation number.
Be sure to get conrmation numbers when making
hotel and rental car reservations. If the physician is ying with a paper ticket, check it when it arrives. The
dates, ight numbers, and times should match those on
the itinerary you prepared.
Put two copies of the itinerary, a copy of the conference registration form, and the ticket (or airline email
for ticketless travel) into an envelope and give it to the
physician. Then, all that’s left is to wish her a good trip!
208 Section III Administrative Medical Assistant Skills
Procedure 10-1 Making Appointments for New Patients
Follow these steps when making an appointment for a
new patient:
1. Obtain the patient’s full name, address, day and
evening phone numbers, reason for the visit, and
name of who referred the patient. This information
helps you determine how soon and for how long
the patient will need to be seen.
2. Explain the office’s payment policy. Ask the
patient to bring insurance information to the office. Patients cannot be expected to make any
required payments unless they are aware of
the policy. You should also verify insurance to
determine whether your office participates in
their plan.
3. Make sure the patient knows where the ofce is located. Give directions if needed. This helps patients
arrive on time.
4. Ask the patient if it’s acceptable to call them at home
or work. Some patients don’t want medically related messages left on voicemail or with a coworker.
5. Double-check your appointment book or computer
screen to make sure you have recorded the appointment for the correct date and time. Mistakes can
cause overbooking, angry patients, and irritated
physicians and staff.
6. Before hanging up, conrm the day, date, and time
of the appointment with the patient. Repeating this
information ensures that no mistakes or misunderstandings have occurred.
7. If another physician referred the patient, make a
note to contact the referring physician’s ofce for
copies of the patient’s records. This will give the
physician information about the patient that he
needs. It also may eliminate the need to repeat
some tests.
Procedure 10-2 Making Appointments for Established Patients
Follow these steps to schedule a return appointment.
1. Find out the reason for the return visit. If a specic
test is to be done, check the schedule to see when
the equipment is available. This will help you offer a
good date and time.
2. Offer the patient a specic date and time. If the
patient doesn’t agree, offer one or two other dates
and times. Just asking the patient, “When would you
like to return?” can create indecision in the patient.
3. Enter the patient’s name and telephone contact number in the appointment book or the computer. Also,
conrm their current insurance to verify that they are
still with a participating plan. Having this information with the appointment makes it easier to call the
patient if you have to cancel or reschedule it.
4. Place the information on an appointment card and
give it to the patient. Repeat aloud to the patient the
day, date, and time of the appointment as you hand
over the card. This step helps the patient remember
the appointment.
5. Double-check your record of the appointment to be
sure you have not made an error. Appointment errors
waste time for everyone, including the patient, staff,
and physician.
6. End your conversation with a pleasant word and
smile. Your friendliness will feel good to a patient
who may be anxious about having to return to the
physician.
Chapter 10 Appointments and Schedules 209
Procedure 10-3
Making Appointments for Patients in Other
Facilities
The steps for arranging referrals, testing and other procedures, or hospitalization are much the same. Follow
these guidelines when making arrangements:
1. Make certain that the requirements of the patient’s
health care plan are met. Many health plans require
that referrals to specialists, hospital admissions,
certain diagnostic tests, and surgical procedures be
approved in advance. The phone numbers to call
will be printed on the patient’s insurance card.
2. Refer to the preferred provider list for the patient’s
health care plan and call a provider on this list.
Many plans have lists of approved physicians, hospitals, and other facilities that patients must use.
If there’s more than one approved provider, let the
patient choose from the list if she wishes.
3. Have the following information available when
you call the provider:
The name and phone number of your ofce and
r
physician
The patient’s name, address, and phone number
r
The reason the patient is being sent to the other
r
provider
How urgent it is that the patient be seen
r
The approval number from the patient’s health
r
care plan if precertication is required.
This information allows the other provider to serve
the patient’s needs.
4. Record the following information in the patient’s
chart when you make the call:
The date and time of the call
r
The name of the person you spoke with.
r
You need this record to document the patient’s care.
5. Ask the person you’re calling to notify you if the
patient doesn’t keep the appointment. If this happens, tell the physician and record the missed appointment in the patient’s chart. This information
also helps document the patient’s care.
6. Write the following on ofce stationery and give or
mail it to the patient:
The name, address, and phone number of the
r
place you are sending the patient
The date and time of the patient’s appointment
r
at this place
This gives the patient a reminder so the appointment
will be kept.
210 Section III Administrative Medical Assistant Skills
Preparing for Externship
During the externship course, you should keep a daily
journal. A journal is like a personal diary. Journaling
is a way to do self-reection about your attitude and
performance at the externship site. Your school may
require a journal, but if not, keep one anyway. Use
a small notebook and use at least one page for each
day on the site. Each day, record the procedures you
participated with and recall how you could have performed each one. Also, write down new terms and
Chapter Recap
● A medical office needs a good and well-managed
appointment system to run smoothly and
efficiently.
● Scheduling systems include manual ones that use
appointment books and computerized ones that use
special software.
● Computerized systems make it easier to meet the
scheduling needs of patients and providers and to
produce updated daily schedules.
● The number of providers, a facility’s size, and the
services it offers all inuence the scheduling system
and methods that work best.
● Methods used to schedule appointments include
xed, double-booking, streaming, clustering, wave,
and modied wave.
abbreviations you encounter each day. Research each
of these so you will know them the next time you see
or hear them. Each day, write down your strength
and challenge you had. An example of strengths
might be receiving a compliment about the way you
interacted with a patient. Weaknesses might include
the need to improve technique when performing specic tasks. This is an area that as a student you need
to accept constructive criticism.
● Scheduling appointments for new and returning
patients requires meeting both the patient’s and the
provider’s needs.
● Appointment cards, phone reminders, and reminder
cards make patients less likely to miss their appointments.
● On many days, emergencies, delays, late patients,
walk-ins, cancellations, and no-shows will require
schedule adjustments.
● Some health care plans may place special requirements
on sending the patients they cover to other providers.
● Extra steps may be needed when scheduling patients for
certain tests, surgical procedures, or hospital admissions.
● In addition to scheduling appointments, you also
may help with organizing the physician’s schedule
and travel plans.
Online Resources for Students
Resources for students available on thepoint.
lww.com include the following:
● Audio Glossary
● Animations
● Competency Evaluation Forms
● Harris CareTracker Case Studies
● Interactive Games & Activities
● Certication Preparation Question Bank
● Videos